"I think people should get to make their own decisions about their bodies as long as doctors are making them informed consumers," Miklos said. "It's a woman's right to say, 'I don't like the way my labia look.'"
While a growing number of women may be looking to the operations to improve the appearance of their vaginas, a significant portion of those seeking these surgeries may be doing it to relieve pain or discomfort.
"If we're talking about helping people who are in pain, it's a different situation," said Tracy.
And the number of those seeking the procedure for pain relief could be larger than once thought. At the June meeting of the International Urogynecological Association in Cancun, Mexico, Miklos and his colleague Robert Moore presented survey research showing that of 135 patients seeking labia reduction, about two-thirds reported that they sought the procedures to relieve pain or discomfort due to their vaginal structure.
"It's irritating and it hurts," he said. "They are uncomfortable in their clothes, and it hurts during intercourse."
Vaginal tightening procedures, Miklos said, are another category of treatment that can have medical indications. These operations involve surgery on the vagina to tighten and resecure the inner tissues to their anchoring structures.
While some women may seek the procedure to restore a tighter feel during sex, Miklos said such surgery is often intended to prevent and treat legitimate conditions such as vaginal prolapse that can follow childbirth or some other trauma.
"These are medical diagnoses," he said. "This isn't some made-up stuff."
Still, procedures such as revirginization, which seeks to create the effect of a restored hymen, and G-spot amplification, in which a filling agent is injected into the front inner wall of the vagina, have no clear medical indication and therefore little justification, according to the American College of Obstetricians and Gynecologists.
Tracy said that more research is needed to weigh the potential benefits against possible risks from cosmetic and nonmedically indicated practice of these techniques.
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